Did you know that you have trillions of bacteria in your gut? Pretty cool huh? Research is increasingly showing that having good gut bacteria is important for mood, nutrition, sleep, immune system, and digestion. Eating a fiber-rich, Mediterranean style diet has been shown to “feed” good bacteria in your gut.

When starting to add more fiber to your diet, start slow. Allow their bodies to adjust to the increase in fiber.

If your kid is already eating a good amount of fiber and still constipated, adding even more fiber might make it worse. It’s best to talk to your child’s doctor/dietician in these situations.

Water

Are your kids drinking enough water? Water is really important to help keep constipation at bay. Water helps to get things “moving.” Having adequate water intake helps to soften stools and stimulate bowel movements.

How much fluid does your kid need each day? It really depends on weight, activity, temperature, etc. But here is an estimate, your 1-4-year-old may need 5-6 cups and your 4-8-year-old may need 7 cups. But keep in mind that this includes fluid from water, milk, other beverages, and food.

Total Daily Fluid intake includes water-filled fruits and veggies. So if you’re thinking that they’re not getting enough water, you can try serving them some water-filled foods.

Examples include:

Watermelon

Strawberries

Oranges

Pineapple

Cucumbers

Bell Peppers

Junk Food

Eating too much junk food can lead to constipation. Your kids (and you too!) need plenty of plant-based fiber. Another thing to think about when it comes to junk food is the water in foods (remember water gets things moving.) For example, Strawberries are 91% water and potato chips are 2% water.

Time On Toliet

You need time on the toilet to have a proper bowel movement. Having at least two long sits on the toilet each day can help reduce constipation.

Doing a long potty sit first thing in the morning and after meals is ideal because there is a reflex for emptying the bowels and it’s the strongest in the morning and shortly after you’ve eaten.

If your kid doesn’t like to sit for very long you can try to give them a book, paper to draw or a tablet.

Also, encourage your kid to relax while on the toilet. Relaxing on the potty helps the anal sphincter open and let stool out.

Exercise

Make sure your kid gets plenty of exercise each day. Exercise is needed to increase muscle contractions in your colon which helps your kid have more regular bowel movements.

In other words, exercise improves bowel movements.

I try to get my kids outside and moving 2-4 hours a day depending on the weather. They go out and ride bikes, climb trees, swing, etc. In the winter its a little more difficult but we try our best to stay active.

Stool Softner or Laxative

Sometimes a stool softener or a laxative is needed. It’s best to discuss the kind and amount with your doctor but some options are:

Miralax

Natural Calm

Ex-Lax

Other things that might help soften stool are probiotics and fermented foods. But start slow as to not cause bowel distress.

Squatty Potty

Have you heard of squatty potty? Squatty Potty is a stool that sits next to the toilet that allows you to elevate your feet while having a bowel movement. Why is this helpful with constipation?

It allows you to relax while pooping, therefore, helping you to fully empty your bowels. The squatty potty gives you the benefit of gravity to get your bowel movement out, making it much easier to poop.

Poop Massage

Have you heard of poop massages? I hadn’t until I started looking for constipation remedies. Kids that are constipated often don’t feel the urge to go so gently massaging their colon can help jumpstart this urge.

You can do poop/colon massages daily after a meal, preferably at the same time each day.

Dealing With Constipation: When Things Get Worse

Sometimes you can do everything mentioned above and STILL have a constipated kid. So what should you do?

See A Doctor

The first thing I want to say is to see a doctor. If you’ve done everything that you’re supposed to do to help ease constipation and it’s not getting better, call your child’s doctor.

They can help you figure out what is going on and may offer other tips that you hadn’t thought of. Maybe they’ll refer you to a specialist. A pediatric gastroenterologist may be able to help you get to the root of your child’s constipation.

Another thing that they may do is an X-ray. An X-ray can show doctors how much stool is in their colon. It also serves as a starting point to know how constipated your kid is. After getting your kid cleaned out you can do another X-ray and then you’re doctor will know that they are cleaned out by comparing the X-rays.

Withholding

One potential reason for constipation that is not getting better is withholding. Does your child withhold their poop?

Some kids simply don’t want to stop playing in order to go. They may be too engrossed in what they’re doing to stop playing and listen to their bodies.

Other kids may have been struggling with constipation for so long that they withhold because they know that it hurts to have a bowel movement so they hold it in to avoid the pain.

Low Muscle Tone

Muscle tone helps to push out their bowel movements. Kids with low muscle tone may have problems physically pushing their poop out. A pediatric occupation therapist may be able to help if this is the case.

Dairy Allergy/Intolerance

Some kids may have a dairy allergy and simply switching to non-dairy milk will relieve constipation. Some researchers speculate that the dairy makes pooping painful so kids withhold, therefore, causing chronic constipation.

Accidents

Does your child have accidents? Having accidents after being potty trained (usually 4 years and up) may be a sign of constipation.

Enuresis

What Is Enuresis? It is involuntary urinating. Meaning pee accidents.

When the colon is so full of poop, the poop presses on the bladder which causes your child to pee more frequently and more urgently.

The stretching of the colon due to constipation can also make the nerves that control the bladder hiccup resulting in accidents. This can happen during the day or at nighttime (bedwetting.)

Encopresis

Encopresis is another potty problem that is the result of constipation. After so long of a child resisting their bowel movement, impacted bowel movements in the colon start to “leak” out, thus causing poop accidents.

This is obviously embarrassing for your child. And another reason to see your child’s doctor.

Getting Your Child Cleaned Out

Your child’s doctor will probably recommend a cleanout. A cleanout is just how it sounds. You’ll spend a weekend getting the colon cleaned out. This usually involves a high dose of laxatives.

If a cleanout doesn’t seem to help or they keep having recurring problems your child’s doctor may recommend that you see a Pediatric Urologist.

Maintenance

After you get your child cleaned out then you’ll need to be in maintenance mode. This just means regular potty sits, healthy diet, regular exercise and usually some sort of laxative.

You may also consider getting a potty watch. A potty watch usually has some sort of silent alarm to let your child know that they need to stop and go potty.

After dealing with chronic constipation for so long it’s going to take time for the colon to shrink back to normal and for your kid to feel the urge to go on their own. This means you’re going to need to be diligent with maintenance.

It’s No Accident

To learn more about potty issues, I highly recommend the book It’s No Accident. It was written by Steve Hodges who is a Pediatric Urologist and an expert on kids’ potty problems.